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1.
Medicine (Baltimore) ; 100(6): e24666, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578597

RESUMO

BACKGROUND: Cardiopulmonary resuscitation (CPR) performance depends on individual ability and training. Well-trained or professional rescuers can maintain high-quality CPR for longer than laypeople. This study aimed to examine the effects of reducing resting intervals on CPR performance, physiological parameters, and hemodynamic parameters during prolonged CPR in well-trained providers. METHODS: The study enrolled 90 volunteers from the paramedic students of our institution. They were randomly divided into 3 groups: 2 minutes, 1 minute 45 seconds, and 1 minute 30 seconds rest groups. Each participant performed 5 cycles of chest compression only CPR (2 min/cycle) with different resting intervals according to grouping. CPR quality, physiological variations, and hemodynamic variations were measured for each cycle and compared across the groups. RESULTS: Of the 90 volunteers, 79 well-trained providers were finally included. The variation of the average chest compression depth across the 5 cycles showed significant differences between the 3 groups: from cycle 1 to 2: 1.2 (3.1) mm, -0.8 (2.0) mm, and -2.0 (3.0) mm in the 2 minutes, 1 minute 45 seconds, and 1 minute 30 seconds groups, respectively (P < .001); from cycle 1 to 3: 0.0 (3.0) mm, -0.7 (3.2) mm, and -2.6 (3.9) mm, respectively (P = .030). However, all 3 groups maintained the recommended rate and chest compression depth for all 5 cycles. Physiological and hemodynamic parameters showed no significant differences between the groups. CONCLUSIONS: Well-trained providers were able to maintain high-quality CPR despite reducing rest intervals. Adjusting the rest interval may help maintain overall CPR quality in special situations or where layperson rescuers are involved.


Assuntos
Reanimação Cardiopulmonar/educação , Hemodinâmica/fisiologia , Qualidade da Assistência à Saúde/estatística & dados numéricos , Descanso/fisiologia , Pessoal Técnico de Saúde/educação , Pessoal Técnico de Saúde/estatística & dados numéricos , Reanimação Cardiopulmonar/estatística & dados numéricos , Oscilação da Parede Torácica/estatística & dados numéricos , Oscilação da Parede Torácica/tendências , Auxiliares de Emergência/educação , Auxiliares de Emergência/estatística & dados numéricos , Fadiga , Feminino , Humanos , Masculino , Fenômenos Fisiológicos/fisiologia , Estudos Prospectivos , Treinamento por Simulação/métodos , Estudantes , Fatores de Tempo , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-32429061

RESUMO

This study compared physiological responses and cognitive performance during simulated work activities in heat to a thermoneutral condition. First responders perform physically demanding activities in a hot environment which may impose additional burdens on tactical personnel during daily tasks. Ten healthy (8 men and 2 women) participants performed two consecutive simulated work activities with two repetitions of each activity (10 min walking on treadmill and 15 sandbag lifts) under heat and thermoneutral conditions. A Stroop color word test (SCWT) and total mood disturbance (TMD) were obtained at first and second baseline (B1, B2), after a 30-min resting period (B3), and recovery (R1). At the end of the trial, core temperature (Tc), skin temperature (tsk), and mean body temperature (Tb) were higher in the heat condition compared to neutral condition (all p ≤ 0.05), whereas oxygen uptake, heart rate, and mean arterial pressure were not significantly different between conditions. There were no differences in scores of SCWT and TMD between conditions. However, TMD was significantly improved after two successive bouts of exercise compared to B3 (all p ≤ 0.05). This investigation shows that two successive simulated work activities did not induce the detrimental influence on thermoregulatory and cognitive responses. Extended work activities in a hot and humid environment may impose a psychophysiological burden and need to be investigated.


Assuntos
Auxiliares de Emergência , Temperatura Alta , Temperatura Corporal , Regulação da Temperatura Corporal , Auxiliares de Emergência/educação , Auxiliares de Emergência/psicologia , Feminino , Frequência Cardíaca , Humanos , Masculino , Temperatura Cutânea , Estudantes
4.
South Med J ; 113(2): 59-63, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32016434

RESUMO

OBJECTIVES: Interfacing with patients with sensory processing difficulties is challenging to healthcare providers and even more problematic for emergency medical services (EMS) personnel in the acute care setting. Sensory training may be an effective nonpharmacologic method to deal with these patient populations. The purpose of this study was to evaluate whether an educational session and placement sensory tools would improve the comfort of EMS providers in the prehospital setting. METHODS: EMS providers from two agencies in the Alabama Gulf EMS System were selected for this study. Preeducation questionnaires were administered to EMS providers to assess their frequency and comfort level in taking care of patients with sensory processing difficulties. The educational session included a video presentation of various topics related to sensory processing difficulties and education on sensory tools. Posteducation questionnaires were administered to EMS providers 3 months posteducational session to assess the use of sensory tools and their comfort in patient care. Comfort level was assessed on a Likert scale of 1 to 10, with 1 being not comfortable at all and 10 being extremely comfortable. We performed descriptive statistics and the nonparametric Wilcoxon signed rank test to compare medians. RESULTS: A total of 177 of 225 (78.6%) EMS providers completed the preeducation questionnaire. In the preeducation period, 159 (89.8%) EMS providers transported patients with sensory processing difficulties. The preeducation median comfort level was 7.5 (range 1-10). At postsurvey, 135 of 177 (76.3%) EMS providers received educational training; 37 (27.4%) used the sensory tools within the previous 3 months. The posteducation median comfort level was 8 (range 3-10). Pre- and post median comfort levels were significantly different using the Wilcoxon signed rank test (P = 0.006). CONCLUSIONS: Sensory training can be an effective method for EMS providers to increase comfort levels in taking care of patients with sensory difficulties. Further research with larger sample sizes is needed to confirm/refute these findings.


Assuntos
Serviços Médicos de Emergência/métodos , Auxiliares de Emergência/educação , Auxiliares de Emergência/psicologia , Medicina de Emergência/educação , Transtornos da Percepção , Adulto , Alabama , Atitude do Pessoal de Saúde , Competência Clínica , Feminino , Humanos , Masculino , Inquéritos e Questionários
5.
Niger J Clin Pract ; 23(1): 54-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31929207

RESUMO

Objectives: The first aid implemented just after the traumatic dental injury (TDI) is of vital importance. This study aims to evaluate the attitudes of emergency medical technicians (EMTs) and paramedics toward TDI and their levels of knowledge about the issue. Subjects and Methods: A questionnaire, which comprised 14 questions, was applied to 389 EMTs and paramedics all across Turkey. The questionnaires were sent to the participants through e-mails, and the results were obtained by an online system. Results: 336 out of 389 EMTs and paramedics (86.4%) mentioned that they did not have any training about the TDI issue. On the other hand, among the ones who mentioned that they received this training, 50.9% suggested that the training was not sufficient. It was observed that 63.5% of the participants encountered cases of injuries in oral and dental regions, and in 83% of these cases the only treatment applied was bleeding intervention. About 75.6% of them think that an avulsed tooth cannot be reimplanted. Conclusion: In conclusion, it was determined that the EMTs and paramedics did not have sufficient and accurate information about the TDI. Lack of knowledge about TDI prevents rapid and accurate intervention to the cases.


Assuntos
Pessoal Técnico de Saúde/educação , Auxiliares de Emergência/educação , Conhecimentos, Atitudes e Prática em Saúde , Fraturas dos Dentes , Traumatismos Dentários , Adulto , Pessoal Técnico de Saúde/psicologia , Atitude do Pessoal de Saúde , Serviços Médicos de Emergência , Auxiliares de Emergência/psicologia , Feminino , Humanos , Masculino , Inquéritos e Questionários , Avulsão Dentária , Turquia , Adulto Jovem
6.
Ulus Travma Acil Cerrahi Derg ; 26(1): 9-14, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31942745

RESUMO

BACKGROUND: The Tashkent city, the capital of the republic of Uzbekistan, started joint project with Korean emergency physicians to improve the quality of their ambulance services in 2016. Ambulance service in Tashkent city has been facing challenges in processing a large number of calls, and low competency of their staff in providing advanced prehospital emergency care. To design an appropriate capacity building training program for ambulance staff, we analyzed the current ambulance service in Tashkent concerning resources and competency of the staff. METHODS: In this study, ambulance staff participated in the constructed survey and pre-validated written test. Statistics and other information were provided by the Ministry of Health of Uzbekistan. RESULTS: Ninety-eight ambulance staff were participated in this study, and more than half (53.1%) of the participants were physicians. The average years of service in the ambulance were 8.71±6.9 years. In the ambulance, drugs were stocked in enough quantity include injections for critical care, except large volume fluids for resuscitation. Only 19 to 52 percent of the ambulances were equipped with essential monitoring devices. Competency for the basic procedure was surveyed higher than 60%, but critical care skills, such as defibrillation, were as low as 18%. The written test resulted in only 41.1% correct answer rate, though it was higher than 60% in the validation test for Korean ambulance staff. Conventional prehospital knowledge and skillset deemed to be essential for ambulance staff were found to be marginal in the test. CONCLUSION: The ambulance staff in Tashkent, Uzbekistan found to have insufficient medical knowledge and clinical decision-making abilities. Training program for ambulance staff in Tashkent should be developed on the basis of the findings in this study.


Assuntos
Ambulâncias , Serviços Médicos de Emergência , Auxiliares de Emergência/educação , Competência Clínica , Currículo , Países em Desenvolvimento , Humanos , Inquéritos e Questionários , Uzbequistão
7.
J Neurointerv Surg ; 12(1): 104-108, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31337733

RESUMO

INTRODUCTION: The shorter the time between the onset of symptoms and reperfusion using endovascular thrombectomy, the better the functional outcome of patients. A training program was designed for emergency medical technicians (EMTs) to learn the gaze-face-arm-speech-time test (G-FAST) score for initiating a prehospital bypass strategy in an urban city. This study aimed to evaluate the effect of the training program on EMTs. METHODS: All EMTs in the city were invited to join the training program. The program consisted of a 30 min lecture and a 20 min video which demonstrated the G-FAST evaluation. The participants underwent tests before and after the program. The tests included (1) a questionnaire of knowledge, attitudes, confidence, and behaviors towards stroke care; and (2) watching 10 different scenarios in a video and answering questions, including eight sub-questions of G-FAST parameters, and choosing a suitable receiving hospital. RESULTS: In total, 1058 EMTs completed the training program. After the program, significant improvement was noted in knowledge, attitudes, and confidence, as well as scenario judgement. The performance of the EMTs in evaluating G-FAST criteria in comatose patients was relatively poor in the pre-test and improved significantly after the training course. Although the participants answered the G-FAST items correctly, they tended to overtriage the patients and refer them to higher-level hospitals. CONCLUSIONS: A short training program can improve the ability to identify stroke patients and choose a suitable receiving hospital. A future training program could put further emphasis on how to evaluate comatose patients and choose a suitable receiving hospital.


Assuntos
Competência Clínica , Serviços Médicos de Emergência/métodos , Auxiliares de Emergência/educação , Acidente Vascular Cerebral/cirurgia , Trombectomia/educação , Trombectomia/métodos , Competência Clínica/normas , Serviços Médicos de Emergência/normas , Auxiliares de Emergência/normas , Feminino , Humanos , Masculino , Acidente Vascular Cerebral/diagnóstico , Trombectomia/normas
8.
Air Med J ; 38(6): 426-430, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31843154

RESUMO

OBJECTIVE: Point-of-care ultrasound is a nascent and growing area of prehospital care. Most previously described ultrasound curricula for paramedics examine a single type of ultrasound scan. Here, we describe the implementation and evaluation of a prehospital ultrasound curriculum using a blended model of traditional didactics and hands-on experience with online prereading. METHODS: We recruited a prospective convenience sample of critical care paramedics without prior ultrasound experience to take part in a 2-day ultrasound course. All participants completed prereading modules built from online resources followed by a didactic review of the material and hands-on practice. Ultrasound examinations included extended focused abdominal sonography in trauma, cardiac ultrasound, thoracic ultrasound, and vascular ultrasound. A written examination evaluated ultrasound theory and image interpretation, and a practical examination evaluated image acquisition. RESULTS: Seventeen critical care paramedics completed the course with a mean grade on the written examination of 76%, with 76% of paramedics achieving the predetermined passing mark of 70% or greater. All paramedics passed the practical examination. CONCLUSION: The implementation of a prehospital critical care ultrasound program is feasible in our provincial emergency medical services system. Further assessment is necessary to determine future knowledge and skill retention as well as clinical application and utility in real-world settings.


Assuntos
Currículo , Auxiliares de Emergência/educação , Ultrassonografia , Adulto , Serviços Médicos de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
9.
J Allied Health ; 48(4): 298-301, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800661

RESUMO

The Pennsylvania College of Technology implemented a region-wide hybrid emergency medical technician (EMT) training course in 2015, following the release of the National Emergency Medical Services Education Standards as well as the Commonwealth of Pennsylvania's transition away from a state-developed EMT exam and towards the EMT exam developed by the National Registry of EMTs. Previous classes were conducted by the training sites in the region utilizing a traditional, classroom-based model. 79.32% of students who completed training within the classes offered by the region between 2007 and 2013 successfully passed the state exam and became certified as EMT's (n=418), compared to 80.52% of the students who completed the current training program conducted by Penn College (n=186). This analysis finds the Penn College program's pass rates on the NREMT cognitive exam (both first attempt and within three attempts) exceed the previous pass rates on the state exam for the region and mirror the national pass rate metrics during the study period. This study concludes that the Penn College hybrid EMT course is an effective method of training new providers for the region.


Assuntos
Auxiliares de Emergência/educação , Certificação/estatística & dados numéricos , Currículo , Avaliação Educacional , Humanos , Pennsylvania , Universidades
10.
Medicine (Baltimore) ; 98(46): e17898, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725637

RESUMO

This study demonstrated a training program of the suction-assisted laryngoscopy assisted decontamination (S.A.L.A.D.) technique for emergency medical technician paramedic (EMT-P). The effectiveness of the training program on the improvements of skills and confidence in managing soiled airway was evaluated.In this pilot before-after study, 41 EMT-P participated in a training program which consisted of 1 training course and 3 evaluation scenarios. The training course included lectures, demonstration, and practice and focused on how to perform endotracheal intubation in soiled airway with the S.A.L.A.D technique. The first scenario was performed on standard airway mannequin head with clean airway (control scenario). The second scenario (pre-training scenario) and the third scenario (post-training scenario) were performed in airway with simulated massive vomiting. The post-training scenario was applied immediately after the training course. All trainees were requested to perform endotracheal intubation for 3 times in each scenario. The "pass" of a scenario was defined as more than twice successful intubation in a scenario. The intubation time, count of successful intubation, pass rate, and the confidence in endotracheal intubation were evaluated.The intubation time in the post-training scenario was significantly shorter than that in the pre-training scenario (P = .031). The pass rate of the control, pre-training, and post-training scenario was 100%, 82.9%, and 92.7%, respectively. The proportion of trainees reporting confident or very confident in endotracheal intubation in soiled airway increased from 22.0% to 97.6% after the training program. Kaplan-Meier analysis revealed that the adjusted hazard ratio of successful intubation for post-training versus pre-training scenario was 2.13 (95% confidence interval of 1.57-2.91).The S.A.L.A.D. technique training could efficiently help EMT-P performing endotracheal intubation during massive vomiting simulation.


Assuntos
Auxiliares de Emergência/educação , Intubação Intratraqueal/métodos , Laringoscopia/educação , Sucção/educação , Vômito/terapia , Adulto , Competência Clínica , Estudos Controlados Antes e Depois , Descontaminação , Desenho de Equipamento , Feminino , Humanos , Capacitação em Serviço , Laringoscopia/métodos , Masculino , Manequins , Pessoa de Meia-Idade , Projetos Piloto , Sucção/métodos
11.
Am J Disaster Med ; 14(2): 113-119, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637692

RESUMO

Mass casualty incident (MCI) can occur at any time and place and health care institutions must be prepared to deal with these incidents. Emergency department staff rarely learn how to triage MCI patients during their medical or nurse degrees, or through on-the-job training. This study aims to evaluate the effect of training and experience on the MCI triage performance of emergency personnel. METHODOLOGY: This was a cross-sectional prospective study that analyzed the performance of 94 emergency department staff on the triage classifications of 50 trauma patients, before and after a short training in MCI triage, while taking into account their academic background and work experience. RESULTS: The participants were assigned initially to one of two groups: low experience if they had less than 5 years of practice, and high experience if they had more than 5 years of practice. In the low experience group, the initial accuracy was 45.76 percent, over triage 45.84 percent, and subtriage 8.38 percent. In the high experience group, the initial accuracy was 53.80 percent, over triage 37.66 percent, and sub triage 8.57 percent. POSTINTERVENTION RESULTS: In the low experience group, the post intervention accuracy was 63.57 percent, over triage 21.15 percent, and subtriage 15.30 percentage. In the high experience group, the postintervention accuracy was 67.66 percentage, over triage 15.19 percentage, and subtriage 17.14 percentage. CONCLUSION: Upon completion of this study, it can be concluded that MCI triage training significantly improved the performance of all those involved in the workshop and that experience plays an important role in MCI triage performance.


Assuntos
Planejamento em Desastres/organização & administração , Planejamento em Desastres/normas , Serviços Médicos de Emergência/organização & administração , Socorristas/educação , Incidentes com Feridos em Massa , Recursos Humanos em Hospital/educação , Triagem/normas , Estudos Transversais , Avaliação Educacional , Serviços Médicos de Emergência/normas , Auxiliares de Emergência/educação , Hospitais Universitários , Humanos , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos
12.
Health Secur ; 17(5): 393-402, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31593509

RESUMO

Little is known about first responders' knowledge of radiation exposure and the training they receive regarding radiological events. Firefighters and emergency medical services (EMS) personnel were surveyed in July 2018 to February 2019 regarding their knowledge of radiation exposure and the radiological event training they had received. Knowledge was assessed using 15 true-false questions. Five types of radiological event training were assessed. A Mann-Whitney test assessed differences in training received by occupation. A linear regression identified predictors of knowledge scores. A total of 433 individuals completed the survey (response rate = 82.9%). Knowledge scores ranged from 5 to 13, with an average of 8.6. Predictors of knowledge included having received more training on radiological transportation incidents or improvised nuclear devices, and being a firefighter. About a quarter (23.6%, n = 102) had not received any of the 5 types of radiological event training. Firefighters received more training than EMS personnel except on nuclear reactor incidents. Only 14% had participated in a radiological event exercise. First responders' knowledge of radiation exposure and prevention measures is low, and many have received either no or very little training on radiological events. The lack of radiation exposure knowledge and radiological event training received, as identified in this study, could result in increased mortality rates. First responder agencies should provide additional radiological event training and exercise opportunities.


Assuntos
Auxiliares de Emergência/educação , Socorristas/educação , Bombeiros/educação , Conhecimentos, Atitudes e Prática em Saúde , Exposição à Radiação , Liberação Nociva de Radioativos , Adolescente , Adulto , Planejamento em Desastres/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
13.
Stroke ; 50(10): 2941-2943, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31545693

RESUMO

Background and Purpose- Emergency medical services (EMS) stroke recognition facilitates rapid care, however, prehospital stroke screening tools rely on signs that are often absent in posterior circulation strokes. We hypothesized that addition of the finger-to-nose (FTN) test to the Cincinnati Prehospital Stroke Scale would improve EMS posterior stroke recognition. Methods- In this controlled before and after study of consecutive EMS transported posterior ischemic strokes, paramedics in a single EMS agency received in-person training in the use of the FTN test. Paramedics at 2 other local EMS agencies served as controls. We compared the change in posterior stroke recognition, door-to-CT times, and alteplase delivery between the FTN (intervention) and control agencies. Results- Over 21 months, 51 posterior circulation strokes were transported by the FTN agency and 88 in the control agencies. Following training, posterior stroke recognition improved from 46% to 74% (P=0.039) in the FTN agency, whereas there was no change in the control agencies (32% before versus 39% after, P=0.467). Mean door-to-CT time in the FTN agency also improved following training (62-41 minutes, P=0.037) but not in the control agencies (58-61 minutes, P=0.771). There was no difference in alteplase delivery. Conclusions- Paramedics trained in the FTN test were more likely to identify posterior stroke. If future studies confirm these findings, such training may expedite the care of posterior stroke patients transported by EMS.


Assuntos
Diagnóstico Precoce , Auxiliares de Emergência/educação , Exame Neurológico/métodos , Acidente Vascular Cerebral/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
15.
J Stroke Cerebrovasc Dis ; 28(9): 2388-2397, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31320270

RESUMO

OBJECTIVE: Improve prehospital identification of acute ischemic stroke patients with large vessel occlusion (LVO) by using a trauma system-based emergency communication center (ECC) to guide the emergency medical service (EMS). METHODS: We trained 24 ECC paramedics in the Emergency Medical Stroke Assessment (EMSA). ECC-guided EMS in performance of the EMSA on patients with suspected stroke. During the second half of the study, we provided focused feedback to ECC after reviewing recorded ECC-EMS interactions. We compared the sensitivity, specificity, and area under the receiver operator characteristics curve (AUC) and 95% confidence interval of ECC-guided EMSA to the NIH Stroke Scale (NIHSS) for predicting a discharge diagnosis of LVO. RESULTS: We enrolled 569 patients from September 2016 through February 2018. Of 463 patients analyzed, 236 (51%) had a discharge diagnosis of stroke and 227 (49%) had a nonstroke diagnosis. There were 45 (19%) stroke patients with LVO. For predicting LVO, there was no significant difference between the EMSA AUC = .68 (.59-.77) and the NIHSS AUC = .73 (.65-.81). An EMSA score greater than or equal to 4 had sensitivity = 75.6 (60.5-87.1) and specificity = 62.4 (57.6-67.1) for LVO. During the first 9 months of the study, the EMSA AUC = .61 (.44-.77) compared to an AUC = .74 (.64-.84) during the second 9 months. CONCLUSIONS: ECC-guided prehospital EMSA is feasible, has similar ability to predict LVO compared to the NIHSS, and has sustained performance over time.


Assuntos
Arteriopatias Oclusivas/diagnóstico , Isquemia Encefálica/diagnóstico , Competência Clínica , Sistemas de Comunicação entre Serviços de Emergência , Serviços Médicos de Emergência/métodos , Auxiliares de Emergência/educação , Capacitação em Serviço/métodos , Acidente Vascular Cerebral/diagnóstico , Idoso , Arteriopatias Oclusivas/fisiopatologia , Arteriopatias Oclusivas/psicologia , Arteriopatias Oclusivas/terapia , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/psicologia , Isquemia Encefálica/terapia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes , Fatores de Risco , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Acidente Vascular Cerebral/terapia , Tempo para o Tratamento
16.
Air Med J ; 38(4): 285-288, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31248539

RESUMO

Advances in point-of-care ultrasound technology have allowed for the extension of emergency medicine ultrasound beyond the walls of the emergency department. Emergency medical system providers may benefit from the use of ultrasound. It has previously been shown that with a brief introductory course, novices can obtain and correctly interpret focused ultrasound examinations. The purpose of this study was to design a theory-driven point-of-care ultrasound curriculum to assess and develop ultrasound skill in prehospital providers. The resultant curriculum outlined in this paper encompasses a large array of skills that may be useful for different prehospital services to use to develop curriculum for their own needs.


Assuntos
Currículo , Serviços Médicos de Emergência , Ultrassonografia , Competência Clínica , Consenso , Técnica Delfos , Auxiliares de Emergência/educação , Humanos , Modelos Educacionais , Sistemas Automatizados de Assistência Junto ao Leito
18.
Pan Afr Med J ; 32: 98, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31223388

RESUMO

Introduction: In South Africa in 2016, injuries accounted for 4 483 deaths of children aged 0-4 years. Prior studies have reported that, in some parts of the country, poor pre-hospital clinical care is a key contributor to the morbidity and mortality of critically ill and injured children. A key component of a coordinated emergency health care system are emergency medical care (EMC) personnel. Here, we assess the knowledge of EMC personnel employed by the Free State Department of Health on aspects of paediatric pre-hospital emergency care. Methods: This descriptive study used a questionnaire survey to obtain data on the knowledge of Free State EMC personnel on aspects of paediatric pre-hospital emergency care. Results: Only 197 of the initial 250 questionnaires distributed were returned, giving a response rate of 78.8%. More than half (51.2%) of the participants across the five districts had inadequate knowledge of paediatric pre-hospital emergency care. The majority of EMC personnel could not calculate the paediatric blood pressure for age and did not know the paediatric Glasgow Coma Scale (74.0% and 53.4% respectively; P < 0.0001 in both cases). Participants attributed inadequate knowledge to limited exposure to paediatrics cases, insufficient training, limited scope of practice, and lack of equipment. Conclusion: Enhancing the knowledge and skills of EMC personnel in paediatrics pre-hospital care through a short learning programme or continuous professional development programme, and providing adequate paediatric emergency equipment, will ensure that comprehensive pre-hospital emergency care is given to paediatric patients in the province.


Assuntos
Competência Clínica , Serviços Médicos de Emergência/métodos , Auxiliares de Emergência/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Pré-Escolar , Estado Terminal , Auxiliares de Emergência/educação , Auxiliares de Emergência/normas , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pediatria , África do Sul , Inquéritos e Questionários , Adulto Jovem
19.
Simul Healthc ; 14(4): 235-240, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31116173

RESUMO

INTRODUCTION: Prior evidence has supported the use of high-fidelity simulation in initial emergency medical services (EMS) education, but there is a dearth of research on whether EMS professionals can also benefit from it. We sought to examine simulation use and years of practice as predictors of insimulation team performance among EMS professionals. The hypothesis is that both the prior participation in simulation events and the accumulated years of practice will predict insimulation performance. METHODS: This cross-sectional study was conducted as part of a simulation-based EMS competition. Paramedic and physician teams were tested. Participants' years of EMS and healthcare practice and their prior participation in simulation events were assessed with a survey and correlated with performance in the competition. RESULTS: Participants were 120 EMS professionals from 51 teams, which was 75% of all competitors. They had in average 8.03 years of healthcare practice and 5.71 years of EMS practice and had previously participated in 4.34 simulation events. The prior participation in simulation events correlated significantly with EMS insimulation performance at the team level (r = 0.40-0.59). In contrast, neither the years of healthcare practice nor the years of EMS practice significantly predicted insimulation team performance. Furthermore, there was no interaction of simulation use and years of practice. CONCLUSIONS: The benefits of simulation use are not limited to initial EMS education but spread also to experienced professionals. Even individuals who have been working in the field for many years may benefit from high-fidelity simulation. Future research should examine whether this also translates into better clinical performance.


Assuntos
Auxiliares de Emergência/educação , Equipe de Assistência ao Paciente/organização & administração , Médicos/organização & administração , Treinamento por Simulação/organização & administração , Adulto , Competência Clínica , Estudos Transversais , Feminino , Processos Grupais , Humanos , Masculino
20.
Pediatr Int ; 61(7): 634-640, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31119808

RESUMO

In July 2007, the Neonatal Cardiopulmonary Resuscitation (NCPR) program in Japan was launched to ensure that all staff involved in perinatal and neonatal medicine can learn and practice NCPR based on the Consensus on Science with Treatment Recommendations developed by the International Liaison Committee on Resuscitation. In 1978 in North America, a working group on pediatric resuscitation was formed by the American Heart Association Emergency Cardiac Care Committee and concluded that the resuscitation of newborns required a different strategy than the resuscitation of adults. The original first edition of the Neonatal Resuscitation Program textbook was published in 1987. The NCPR program consists of three courses for health-care providers and two courses for instructors. A course and B course are for newly certified health-care providers and course S is for health-care providers who are renewing their certification. As of 31 March 2019, 3,227 advanced instructors (I instructor) and 1,877 basic instructors (J instructor) were trained to teach A, B, and S courses to health-care providers on the basis of their license. In total 7,075 A courses and 4,012 B courses were held; 131 651 people attended A course or B course of the NCPR program, and 77 367 were certified. A total of 1,865 S courses, which were developed in 2015, were held and 12 875 people attended this course. Here, we introduce the background, purpose, history, and content of the development of the NCPR program in Japan.


Assuntos
Reanimação Cardiopulmonar/educação , Educação Médica Continuada/métodos , Educação Continuada em Enfermagem/métodos , Auxiliares de Emergência/educação , Tocologia/educação , Neonatologia/educação , Educação Médica Continuada/organização & administração , Educação Médica Continuada/estatística & dados numéricos , Educação Continuada em Enfermagem/organização & administração , Educação Continuada em Enfermagem/estatística & dados numéricos , Humanos , Recém-Nascido , Japão , América do Norte , Assistência Perinatal/métodos , Assistência Perinatal/organização & administração , Guias de Prática Clínica como Assunto , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
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